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Long-term Results after Surgical Excision of Sub-foveal Choroidal Neo-vascular Membranes
1Gabel A., 1Laue J., 1Heimann H., 1Jandeck C., 1Kellner U., 2Bornfeld N., 1Foerster M. H.,
1Freie Universität Berlin, Klinikum Benjamin Franklin, Augenklinik (Berlin)
2Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde, Abt. Hinterer Augenabschnitt (Essen)
Purpose: The surgical excision is one of the therapy options of subfoveal choroidal neovascular membranes. The long-term results with regard to postoperative complications, development of visual acuity and the risk of recurrence are evaluated.
Methods: Retrospective analysis and reexamination of patients who underwent surgical excision of subfoveal choroidal neovascular membranes between March 1994 and December 2000 in UKBF. 49 eyes of 48 patients (70 % CNV in AMD, 12 % CNV in POHS and 12 % idiopathic CNV) who were treated with a pars plana vitrectomy, retinotomy, extraction of CNV followed by instillation of SF6-Gas were analyzed. Follow-up time ranged from 12 to 75 months (median 28 months).
Results: In the postoperative course, 15 % of the eyes developed a retinal detachment and 39 % cataracta complicata. 23 % of eyes showed a persisting CNV or recurrence of the CNV. 41 % of eyes were reoperated at least once (introcular surgery, laser coagulation, PDT). With a poor initial visual acuity of finger counting to 0,4 (median 1/20), 40 % of patients were stabilized (± 3 lines) on a low level of visual acuity.
Conclusions: The surgical excision may be an option for selected patients suffering from subfoveal choroidal neovascular membranes, but the risk of complications is high.